Göldeli O, Dursun E, Komsuoglu B
Department of Medicine, Kocaeli University Medical School, Izmit, Turkey.
J Rheumatol. 1998 Mar;25(3):447-50.
To determine the value of dispersion of ventricular repolarization as a diagnostic tool to assess the risk for ventricular arrhythmias in patients with rheumatoid arthritis (RA).
We examined 42 patients with RA (age 44+/-4.8 yrs; 32 women and 10 men) and 42 age matched healthy subjects as the control group. Repolarization dispersion variables were calculated based on the difference between maximal and minimal values of QT, QTc, JT, and JTc (QTd, QTc-d, JTd, and JTc-d, respectively) from 12 lead electrocardiographic (ECG) recording at 50 mm/s. The frequency of ventricular arrhythmias by means of 24 h ambulatory ECG monitoring was investigated. A grade of > 3 ventricular arrhythmias according to modified Lown and Wolf classification was accepted as complex arrhythmias.
We found QT and QTc intervals 392+/-20 and 409+/-38 ms in patients; values in controls were 387+/-22 and 400+/-14 ms, respectively; p > 0.05. QTd, QTc-d, JTd, and JTc-d intervals were 61.6+/-1.6, 77.6+/-1.1, 72.5+/-1.8, and 93.3+/-1.5 ms in patients and 40.3+/-0.9, 55+/-1.2, 42.6+/-0.4, and 52.9+/-0.8 ms in controls, respectively; p < 0.001. Thirty-two of the patients had complex premature ventricular complexes during 24 h ECG and the prevalence of premature ventricular complexes was found to be higher than in controls (p < 0.001). No correlation was found between complex premature ventricular complexes and QT, but there was a correlation between complex premature ventricular complexes and dispersion variables in patients with RA.
Striking increases in QT dispersion indicating regional inhomogeneity of ventricular repolarization were noted in patients with RA. QT dispersion might be a useful marker of cardiovascular morbidity and mortality due to complex ventricular arrhythmias in patients with RA.
确定心室复极离散度作为评估类风湿关节炎（RA）患者室性心律失常风险的诊断工具的价值。
我们检查了42例RA患者（年龄44±4.8岁；32名女性和10名男性）以及42名年龄匹配的健康受试者作为对照组。复极离散度变量基于50mm/s的12导联心电图（ECG）记录中QT、QTc、JT和JTc的最大值与最小值之间的差值计算得出（分别为QTd、QTc-d、JTd和JTc-d）。通过24小时动态心电图监测调查室性心律失常的发生频率。根据改良的洛恩和沃尔夫分类法，室性心律失常>3级被视为复杂性心律失常。
我们发现患者的QT和QTc间期分别为392±20和409±38毫秒；对照组的值分别为387±22和400±14毫秒；p>0.05。患者的QTd、QTc-d、JTd和JTc-d间期分别为61.6±1.6、77.6±1.1、72.5±1.8和93.3±1.5毫秒，对照组分别为40.3±0.9、55±1.2、42.6±0.4和52.9±0.8毫秒；p<0.001。32例患者在24小时心电图检查中有复杂性室性早搏，室性早搏的发生率高于对照组（p<0.001）。在RA患者中，复杂性室性早搏与QT之间未发现相关性，但与复极离散度变量之间存在相关性。
在RA患者中观察到QT离散度显著增加，提示心室复极存在区域性不均一性。QT离散度可能是RA患者因复杂性室性心律失常导致心血管发病和死亡的有用标志物。
